Coroner: Michael Jackson given amount of anesthetic used in 'major surgery' [Updated]
In the last hours of his life, Michael Jackson was given a powerful anesthetic at a level equivalent to what would be used in a “major surgery” and in a manner that did not live up to medical standards, according to the autopsy report on the pop icon released Monday by the Los Angeles County coroner's office.
“The standard of care for administering propofol was not met,” coroners’ examiners wrote in the report. “Recommended equipment for patient monitoring, precision dosing, and resuscitation was not present.”
The report said Jackson died of “acute propofol intoxication” administered by another. Coroner’s officials described a scene around Jackson's bedside that showed a host of problems in using propofol at such a high level.
An oxygen tank was empty and equipment disconnected, and there were no monitors or controlled infusion pump for intravenous administration, they wrote.
They also found that an anesthesiologist would have noted the other sedative drugs in Jackson’s system would have increased the propofol’s effect on the singer’s lungs and heart. In addition to propofol, Jackson’s blood contained lidocaine, diazepam, nordiazepam, lorazepam, midazolam and ephedrine.“
[Updated at 2:08 p.m.: There are NO reports of [propofol's] use for insomnia relief, to my knowledge,” anesthesiology consultant Selma Calmes wrote in the report, underlining and capitalizing the word "no."
“The only reports of its use in homes are cases of fatal abuse (first reported in 1992), suicide, murder and accident,” she wrote.
Because of the risks associated with the drug, it should be administered only by anesthesiologists or other supervised anesthesia providers, trained to recognize respiratory or cardiac problems that can arise, Calmes wrote.
“Full patient monitoring is required any time propofol is given,” she wrote.
Precision in the drug’s dosage through a controlled pump is necessary because “of the narrow margin between mere sedation and full general anesthesia,” she wrote. “The levels of propofol found on [the] toxicology exam are similar to those found during general anesthesia for major surgery (intra-abdominal) with propofol infusions.”]
-- Victoria Kim at the L.A. County coroner's office
Photo: Murray arrives in court. Don Bartlelli / L.A. Times